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成人穿透伤创伤患者的运输方式与生存之间的关联:警察与地面救护车运输的匹配队列研究

Association between Mode of Transportation and Survival in Adult Trauma Patients with Penetrating Injuries: Matched Cohort Study between Police and Ground Ambulance Transport.

作者信息

Abou Arbid Samer A, Bachir Rana H, El Sayed Mazen J

机构信息

Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon.

Emergency Medical Services and Prehospital Care Program, American University of Beirut Medical Center, Beirut, Lebanon.

出版信息

Prehosp Disaster Med. 2022 Mar 8:1-8. doi: 10.1017/S1049023X22000346.

Abstract

INTRODUCTION

Police transport (PT) of penetrating trauma patients has the potential to improve survival rates. There are no well-established guidelines for PT of penetrating trauma patients.

STUDY OBJECTIVE

This study examines the association between survival rate to hospital discharge of adult penetrating trauma patients and mode of transport (PT versus ground ambulance [GA]).

METHODS

A retrospective, matched cohort study was conducted using the United States (US) National Trauma Data Bank (NTDB). All adult penetrating injury patients transported by police to trauma centers were identified and matched (one-to-four) to patients transported by GA for analysis. Descriptive analysis was carried out. The patients' demographic and clinical characteristics were tabulated and stratified by the transport mode.

RESULTS

Out of the 733 patients with penetrating injuries, ground Emergency Medical Services (EMS) transported 513 patients and police transported 220 patients. Most patients were 16-64 years of age with a male (95.6%) and Black/African American race (79.0%) predominance. Firearm-related injuries (68.8%) were the most common mechanism of injury with the majority of injuries involving the body extremities (62.9%). Open wounds were the most common nature of injury (75.7%). The overall survival rate to hospital discharge was similar for patients transported by GA and by police (94.5% versus 92.7%; P = .343).

CONCLUSION

In this study, patients with penetrating trauma transported by police had similar outcomes to those transported by GA. As such, PT in penetrating trauma appears to be effective. Detailed protocols should be developed to further improve resource utilization and outcomes.

摘要

引言

穿透性创伤患者的警方转运(PT)有可能提高生存率。目前尚无针对穿透性创伤患者警方转运的成熟指南。

研究目的

本研究探讨成年穿透性创伤患者出院生存率与转运方式(警方转运与地面救护车[GA]转运)之间的关联。

方法

使用美国国家创伤数据库(NTDB)进行了一项回顾性匹配队列研究。确定所有由警方转运至创伤中心的成年穿透伤患者,并与由地面救护车转运的患者进行(1:4)匹配以进行分析。进行了描述性分析。患者的人口统计学和临床特征按转运方式列表并分层。

结果

在733例穿透伤患者中,地面紧急医疗服务(EMS)转运了513例患者,警方转运了220例患者。大多数患者年龄在16 - 64岁之间,以男性(95.6%)和黑人/非裔美国人(79.0%)为主。与枪支相关的损伤(68.8%)是最常见的致伤机制,大多数损伤累及肢体(62.9%)。开放性伤口是最常见的损伤类型(75.7%)。由地面救护车转运和警方转运的患者出院时的总体生存率相似(94.5%对92.7%;P = 0.343)。

结论

在本研究中,由警方转运的穿透性创伤患者与由地面救护车转运的患者结局相似。因此,穿透性创伤的警方转运似乎是有效的。应制定详细方案以进一步提高资源利用和改善结局。

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